METAANALYSIS OF EFFECTIVENESS OF INTERVENTIONS TO INCREASE INFLUENZA IMMUNIZATION RATES AMONG HIGH-RISK POPULATION GROUPS

Public health interventions have been developed to increase influenza immunization rates among the high-risk elders and patients suffering f rom cardiopulmonary, metabolic, and other chronic conditions. The rela tive effectiveness of alternative intervention strategies is not yet w ell understood. Determination of the most effective strategy should co nsider characteristics of the target population and the health care de livery system. This meta-analysis of intervention evaluation studies h ighlights the importance of considering the baseline immunization rate of the target population in selecting the most effective strategy. Wh ile the analysis confirms the feasibility of achieving the 60 percent target coverage established in Healthy People 2000, the results also s uggest that as coverage levels increase, single-faceted patient-focuse d interventions may need to be strengthened by the addition of complem entary changes in provider behaviors and/or the delivery system. Furth er research is needed to identify the most cost-effective combination of intervention strategies, particularly in populations with higher im munization coverage.